Razi Journal of Medical Sciences

fa تبیین مدل فرسودگی تحصیلی دانشجویان علوم پزشکی براساس سرسختی تحصیلی، مسئولیت پذیری تحصیلی و تاب آوری اخلاقی Medical Students’ Academic Burnout Model Based on Academic Tenacity, Academic Responsibility, and Moral Resilience روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;">زمینه و هدف: دانشجویان به دلیل انجام تکالیف درسی برای موفقیت تحصیلی به نوعی شاغل محسوب می‌شوند. دانشجویان پزشکی بیش از سایر دانشجویان به دلیل مرگ و میر بیماران، ویزیت بیش از حد بیماران، مسئولیت تصمیم‌گیری، انجام شیفت‌های شب و ... مستعد فرسودگی هستند. لذا، این پژوهش با هدف، تبیین مدل فرسودگی تحصیلی براساس سرسختی، تاب‌آوری و مسئولیت پذیری تحصیلی در دانشجویان علوم پزشکی صورت گرفته است. روش کار: پژوهش حاضر از نوع توصیفی- همبستگی (با استفاده از مدل یابی روابط ساختاری) است. جامعه آماری این مطالعه را تمامی دانشجویان رشته پزشکی عمومی و دستیاری، دانشجویان کارشناسی، کارشناسی ارشد و دکتری حرفه ای رشته های علوم پایه، توانبخشی، پیراپزشکی و روانشناسی که در سال تحصیلی 1401- 1400 در دانشگاه علوم پزشکی ایران در شهر تهران مشغول به تحصیل بودند، تشکیل داده اند که از بین آنها 216 نفر به صورت در دسترس انتخاب شدند. معیار خروج از مطالعه، عدم تمایل، دانشجویان  دوره کاردانی و کارشناسی کمتر از ترم 6 بوده است. در این مطالعه دانشجویان به پرسشنامه های جمعیت شناختی، فرسودگی، سرسختی، تاب آوری ومسئولیت پذیری تحصیلی پاسخ دادند. برای تحلیل داده ها از آزمون های همبستگی پیرسون، سوبل، بوت استراپ و مدل یابی معادلات ساختاری SEM از طریق نرم افزار SPSS و Amos (نسخه 23) استفاده شده است. یافته‌ها: در اجرای مدلیابی معادله ساختاری کوواریانس محور و بوت استراپ با مد نظر قرار دادن حد بالای نسبت حجم نمونه به تعداد متغیرهای مطالعه و رابطه نرمالیتی چند متغیره ؛ با توجه به حجم بالای نمونه ، نرمال بودن دادهها در خروجی آزمون کولموگروف-اسمیرنوف و معنی داری ضرایب همبستگی و شاخص مجذور کای مدل فرضی در سطح آماری 05/0>P؛ متغیر مسئولیت پذیری تحصیلی به عنوان یک متغیر تعدیل کننده، میانجی رابطه ی بین سرسختی و فرسودگی تحصیلی و تابآوری و فرسودگی تحصیلی قلمداد می‌شود. نتیجه‌گیری: در تبیین مدل پیشنهادی می‌توان گفت، تاب آوری به افراد قدرت مقابله ی سالم در برابر مشکلات  زندگی و سرسختی به انعطاف پذیری همراه با تعهد و درک دانشجویان در برابر افت تحصیلی اشاره دارد. از طرفی، بستر اصلی مسئولیت پذیری، طرز فکر و باورهای افراد نسبت به خود، دیگران و رخدادهای محیط اطراف است. پس، افراد با پذیرش مسئولیت ضمن برخورداری از یک آمادگی لازم در لحظه برای حرکت به سوی اهداف خود و احساس ارزشمندی و تعهد به برآورده کردن نیازهای خود و دیگران، ضمن تقویت احساس مسئولیت، سرسختی و تاب آوری خود از بروز فرسودگی پیشگیری می‌کنند.  </div> <div style="text-align: justify;">Background & Aims: Every year knowledge-seekers are admitted into universities as new students. . Researchers believe that students, like employees and workers, engage in compulsive and regular activities [and] on specific goals. Therefore, students' activities can be considered as "work" and "occupation" (1). Excessive study workload, content presentation, professor’s requests and expectations of students, highly educational expenses,  and apprenticeship in underrepresented areas in some educational fields such as medicine led to exhaustion, lack of motivation, disinterest to courses, apathy to educational settings and indifference to rules and regulations, and discouragement. Overload of these problems in the long term led to confusion, emotional disturbances and finally burnout. Medical students, rather than other students, are more prone to distress due to patient mortality, exposure to patients with complicated care needs, interpersonal challenges, high workload, visiting too many patients in a day, decision-making responsibility in emergencies without having sufficient knowledge, accountability against their decisions, working under mental pressure to avoid medical errors, being exposed to violence and threats in the workplace, and doing night shifts (3). Burnout is a psychological and emotional fatigue that is the result of chronic stress syndrome such as role burden, pressure and time constraints, and lack of necessary resources to conduct tasks and duties. Research has indicated that academic burnout is similar to job burnout in terms of its features, antecedents, and outcomes. Job burnout is defined as one of the major health indicators of psychological health with three dimensions of fatigue, apathy (doubt and pessimism), and inefficiency (4). Academic burnout in students means feeling exhausted to complete assignments and studying (academic fatigue), having pessimistic attitude to education and educational content (academic disinterest), and a sense of academic incompetence (inefficiency) (2). Students suffering from burnout during their years of study will experience negative effects of burnout and will be less efficient to perform their job tasks and duties and will be less innovative in the future. Psychological research indicates that diverse internal and external factors affect academic burnout. One of these intrapersonal factors is resilience (4). Resilience is a promising and pleasant solution considering stressful situations and people’s inherent capacity to respond and endure the situation and the experience of natural growth in stressful conditions (6). According to Baratz (2015), moral resilience is the ability to cope with situations using values that people believe in, even if to follow them is difficult. Rushton (2016) and Lachman (2016) considering the definition of resilience, believe that it is the ability to return to the primary status and successful coping despite distress and adverse conditions, and it has two components. The first factor is the existing situation and problem that includes moral themes (moral adversity) (7). And the second factor is maintaining coherence and integrity according to personal beliefs and values and performing an action to overcome moral issues. The other variable that could affect academic burnout is responsibility. From Fromm’s point of view, responsibility is an absolute need and an internal commitment of the individual to perform all the responsibilities favorably and it originates from within the individual. Chamuru et al. (cited by Yuzbashi, 2018) found that discipline and achievement orientation, carefulness, persistence, and punctuality are individual performance predictors in different fields such as academic success. On the other hand, irresponsibility in education leads to consecutive failures and quitting the program of study (1-13). Tenacity as a personal characteristic is the source of resistance against life distressful events (9). It is a personality construct that includes committed direction (versus self- alienation), control (versus low power), and understanding the changes and life needs as challenge (versus threats). According to Benishiek and Lopez (2001), students who choose challenging academic programs adopt a behavior that supports them to overcome difficulties of their study program and regulate their emotional reactions when receiving feedback (10). Kobasa theory (1998) indicates that three processes of cognitive evaluation (control, commitment, and the ability to challenge), stability and perseverance are related to the confrontation time with challenging life events (9). Since medical students are responsible for maintaining and ensuring people’s health in the future, to conduct their roles as experts or health care providers (therapists) competently, educational systems must be aware of the stress inducing factors affecting them during their challenging prolonged study years during which they experience unfortunate incidences. There is no doubt that neglecting the problems and their accumulation from one hand led to waste of financial and human resources of educational departments of the universities; and, on the other hand lowers the quality of health care provision at the societal level. Therefore, considering the aforementioned, this study was an attempt to investigate the relationship between the influencing variables of academic tenacity, academic responsibility, and morale resilience on the academic burnout of the medical students and defining an academic burnout model based on these variables. Methods: The current research is of a descriptive-correlation type (using modeling of structural relationships). The statistical population of this research is all general medical students and assistants. Also, undergraduate students of the 6th semester and above, master's degree and professional doctorate in the fields of basic sciences, rehabilitation, Para medicine and psychology, who were studying in the academic year 1400-1401 at Iran University of Medical Sciences in Tehran and among them, 216 people were selected as available. The criterion of dropping out of studies, unwillingness, for associate and bachelor students was lower than the sixth semester. In this study, students answered questionnaires about demographic information, job burnout, tenacity, moral resilience, and academic responsibility. For data analysis, Pearson, Sobel, bootstrap correlation tests and SEM structural equation modeling were used using SPSS and Amos software (version 23). Results: Considering that the chi-square index of the hypothetical model was statistically significant at the level of P < 0.05, therefore, the positive relationship of the academic responsibility variable as a moderating variable mediates the relationship between stubbornness and academic burnout and the relationship between moral and job resilience. Conclusion: In explaining the proposed model, it can be said that resilience does not limit stress, but rather gives people the strength to deal with the problems ahead and move with the flow of life. Academic tenacity also refers to flexibility along with the commitment to carry out scientific and professional activities and follow up and understand students against academic failure. On the other hand, the main basis of responsibility is the way of thinking or attitude and belief of people towards themselves, others and events and happenings in the environment. Therefore, by accepting responsibility, people have the potential and readiness to move towards their goals in the moment so that they can enjoy doing their work and strengthen their sense of responsibility with a sense of worth and commitment to meet their needs. Do others. This sense of responsibility leads to increased tenacity and flexibility and reduces burnout in the same proportion. </div> فرسودگی تحصیلی, تاب آوری تحصیلی, سرسختی تحصیلی, مسئولیت پذیری تحصیلی, دانشجویان علوم پزشکی Academic burnout, Academic resilience, Academic tenacity, Academic responsibility, Medical students 1 13 http://rjms.iums.ac.ir/browse.php?a_code=A-10-7469-1&slc_lang=fa&sid=1 Mehrangiz Pashapour Badr مهرانگیز پاشاپور بدر mehripashapour@gmail.com 3900319475328460089876 0009-0001-7452-4718 Yes MA of Psychology, Payame-Noor University, Bonab Branch, Bonab, East Azerbaijan, Iran; Central Library expert, Tehran, Iran کارشناسی ارشد رشته روانشناسی عمومی، دانشگاه پیام نور، آذربایجان شرقی مرکز بناب؛ کارشناس کتب مرجع و مسئول سالن طبقه ششم کتابخانه مرکزی، تهران، ایران Mozaffar Ghaffari Bagtash مظفر غفاری بگتاش Mozaffar.ghaffari@pnu.ac.ir 3900319475328460089877 3900319475328460089877 No Assistant Professor, Payame-Noor University, Bonab Branch, Bonab, East Azerbaijan, Iran دکتری روانشناسی، استادیار، دانشگاه پیام نور، بناب، ایران